Volvulus of Small Bowel Caused by GISTs: Case Report and Literature Review  

作　　者：Muhaned Alhassan Ayman Barghash Hatem Al-Saadi Muhaned Alhassan;Ayman Barghash;Hatem Al-Saadi(Department of General Surgery, Sohar Hospital, Sohar, Oman;Sohar Hospital, Sohar, Oman)

机构地区：[1]Department of General Surgery, Sohar Hospital, Sohar, Oman [2]Sohar Hospital, Sohar, Oman

出　　处：《Case Reports in Clinical Medicine》2022年第5期200-205,共6页临床医学病理报告（英文）

摘　　要：Introduction: Gastrointestinal stromal tumors (GISTs) originating from the interstitial cells of Cajal and GISTs are the most frequent mesenchymal tumors in the gastrointestinal tract (20% to 30% occur in the small intestine). Most small-intestinal neoplasms are asymptomatic. The most common mode of presentation is partial small bowel obstruction, with associated symptoms of colicky abdominal pain, abdominal distention, nausea, and vomiting. Obstruction can be caused by luminal narrowing by the tumor itself or intussusception. Case Presentation: We presented an 85-year-old lady presented with acute intestinal obstruction and CT abdomen with contrast revealed, a large well defined solid mass lesion, enhanced in the arterial phase and inseparable from the jejunal loops and it measures 09 × 08 × 07 cm, likely GISTs with secondary volvulus of the small bowel. Emergency laparotomy with complete resection of the tumor and end-to-end anastomosis of jejunum was done. Discussion: Small-intestinal GISTs should be treated with segmental intestinal resection. If the diagnosis is known prior to resection, wide lymphadenectomy can be avoided as GISTs are rarely associated with lymph node metastases. GISTs are resistant to conventional chemotherapy agents. Imatinib (Gleevec) is a tyrosine kinase inhibitor with potent activity against the tyrosine kinase KIT and is used in those with metastatic disease and as an adjuvant chemotherapeutic agent.Introduction: Gastrointestinal stromal tumors (GISTs) originating from the interstitial cells of Cajal and GISTs are the most frequent mesenchymal tumors in the gastrointestinal tract (20% to 30% occur in the small intestine). Most small-intestinal neoplasms are asymptomatic. The most common mode of presentation is partial small bowel obstruction, with associated symptoms of colicky abdominal pain, abdominal distention, nausea, and vomiting. Obstruction can be caused by luminal narrowing by the tumor itself or intussusception. Case Presentation: We presented an 85-year-old lady presented with acute intestinal obstruction and CT abdomen with contrast revealed, a large well defined solid mass lesion, enhanced in the arterial phase and inseparable from the jejunal loops and it measures 09 × 08 × 07 cm, likely GISTs with secondary volvulus of the small bowel. Emergency laparotomy with complete resection of the tumor and end-to-end anastomosis of jejunum was done. Discussion: Small-intestinal GISTs should be treated with segmental intestinal resection. If the diagnosis is known prior to resection, wide lymphadenectomy can be avoided as GISTs are rarely associated with lymph node metastases. GISTs are resistant to conventional chemotherapy agents. Imatinib (Gleevec) is a tyrosine kinase inhibitor with potent activity against the tyrosine kinase KIT and is used in those with metastatic disease and as an adjuvant chemotherapeutic agent.

关 键 词：GISTS Small Intestine MRI CT Scan IMATINIB Tyrosine Kinase Inhibitor 

分 类 号：R73[医药卫生—肿瘤]